Healthcare Provider Details

I. General information

NPI: 1225559677
Provider Name (Legal Business Name): AMY TURNER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W 1ST ST
MOREHEAD KY
40351-1504
US

IV. Provider business mailing address

120 PATTIES LICK RD
MOREHEAD KY
40351-7348
US

V. Phone/Fax

Practice location:
  • Phone: 800-928-3049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: